WASHINGTON -- Half of the U.S. Army's 36 medical facilities have failed for two years to meet Pentagon standards of providing a physician within a week for routine care.

USA Today reported Tuesday that the Army paid nearly $1 billion last year for outside referrals, up from $200 million in 2000, as it tries to find enough medical personnel to care for military personnel and their families.

"If you're sending someone off into harm's way, if you're asking them to do the nation's business, you need to take care of them," Col. Scott Goodrich, commander at Winn Army Hospital at Fort Stewart, Ga., told the newspaper. "Whenever we can't provide the care we need to a soldier, that's very, very painful to me."

The shortage of medical personnel at Winn and other military medical facilities is caused by the need for doctors in Iraq, a shortage of Reserve medical professionals and the long process of hiring civilian replacements, Maj. Gen. Gale Pollock, the Army's acting surgeon general, told USA Today.

The Army's current staff of 4,170 doctors is 180 short of what it needs. Pollack said she hopes a Pentagon plan to expand the Army by 65,000 people will give her the doctors she needs.